Viral sexually transmitted infections II Flashcards

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1
Q

What symptoms often accompany HSV infection?

A

Fever, inguinal adenopathy, malaise

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2
Q

What are the symptoms of recurrent HSV lesions?

A
  1. 3-5 discrete lesions 2. Vulvar irritation 3. Prodrome of tingling and pain 4. Heal within 7-10 days
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3
Q

What proportion of neonatal herpes infections involve encephalitis with or without skin lesions?

A

1/3

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4
Q

Is herpesvirus enveloped or non-enveloped?

A

Enveloped

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5
Q

What is the genome for HSV?

A

dsDNA

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6
Q

Where is latent infection established in HSV infection?

A

Sensory neuron cell body

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7
Q

What are the transmission routes for HSV?

A
  1. Direct contact 2. Saliva 3. Sexual transmission of genital herpes
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8
Q

What is seen on a positive Tzanck smear?

A

Cytopathic effect of HSV as well as large multinucleated cells

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9
Q

How is HSV-1 differentiated from HSV-2 in the lab?

A
  1. PCR 2. Immunocytochemistry to detect viral antigens
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10
Q

What is the treatment for genital herpes?

A
  1. Primary - oral antiviral 2. Recurrent - long term oral antiviral
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11
Q

Do anti-herpetic drugs act on the latent stage of infection?

A

No

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12
Q

What step in HSV infection is critical for acyclovir therapy to be effective?

A

Acyclovir must be phosphorylated by viral thymidine kinase

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13
Q

After phosphorylation by viral thymidine kinase, how does acyclovir inhibit HSV replication?

A

Triphosphate form is produced, which looks like a nucleotide 2. Viral DNA polymerase is inhibited

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14
Q

Acyclovir is effective against what population of cells during an HSV infection?

A

Only effective against the infected cells

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15
Q

What drugs are used in cases of acyclovir-resistant HSV infections?

A

Nonnucleoside inhibitors (eg Foscarnet)

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16
Q

What do nonnucleoside inhibitors target in HSV infections?

A

Viral DNA polymerase (but do not require thymidine kinase phosphorylation)

17
Q

What is the morphology of HPV genital warts?

A
  1. Hyperkeratotic, firm, exophilic papules 2. 1-2 cm in diameter
18
Q

What are the symptoms associated with HPV genital warts?

A
  1. 75% asymptomatic 2. Itching, pain, burning
19
Q

HPV belongs to what virus family?

A

Papovaviridae

20
Q

Is HPV enveloped or non-enveloped?

A

Non-enveloped

21
Q

What is the HPV genome?

A

dsDNA

22
Q

How is HPV replication linked to tissue differentiation?

A
  1. HPV replicates in basal epithelium, then moves upward during later stages of replication 2. Three dimensional structure is critical for replication
23
Q

Which HPV strains are at high risk for cancer development?

A
  1. 16, 18, 31, 33 2. Mucosal / anogenital class
24
Q

Which HPV strain has the highest prevalence of cervical cancer?

A

HPV-16

25
Q

What is the pathogenesis of HPV-induced cancer?

A

Infected cells leave HPV life cycle and upregulate E6 and E7 by inactivating negative regulator E2

26
Q

What are the roles of E6 and E7 in a cell?

A

E6 inactivates p53, E7 inactivates Rb

27
Q

What is the relationship between E6, E7, and E2?

A

E2 is a negative regulator of E6 and E7

28
Q

What are histological markers for HPV?

A

Hyperkeratosis and koilocytes

29
Q

What are koilocytes?

A

Enlarged keratinocytes that contain irregular hyperchromatic nuclei surrounded by a characteristic halo (seen in HPV pap smears)

30
Q

What laboratory tests are used to diagnose HPV?

A

PCR, pap smear

31
Q

HPV vaccines are made in what medium?

A

Yeast

32
Q

HPV vaccines are prepared from what proteins?

A

Viral capsid proteins

33
Q

Gardasil protects against which HPV strains?

A

6, 11, 16, 18

34
Q

Cervarix protects against which HPV vaccines?

A

16, 18

35
Q

What are the HPV vaccination recommendations for girls?

A

Quadrivalent or bivalent vaccine for all girls 11-12 yo

36
Q

What are the HPV vaccination recommendations for boys?

A

Quadrivalent for all boys 11-12 yo